Pre-diagnostic allostatic load and health-related quality of life in a cohort of Black breast cancer survivors

• Published in: Breast cancer research and treatment 2020-12, Vol.184 (3), p.901-914
• Main Authors: Xing, Cathleen Y., Doose, Michelle, Qin, Bo, Lin, Yong, Carson, Tiffany L., Plascak, Jesse J., Demissie, Kitaw, Hong, Chi-Chen, Bandera, Elisa V., Llanos, Adana A. M.
• Format: Article
• Language: English
• Subjects: Analysis; Breast cancer; Cancer; Cancer research; Cancer survivors; Cancer therapies; Care and treatment; Diagnosis; Epidemiology; Health aspects; Inflammation; Longitudinal studies; Medical records; Medicine; Medicine & Public Health; Metabolism; Metastases; Metastasis; Oncology; Oncology, Experimental; Quality of life; Regression analysis; Statistical analysis; Women; Womens health
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-020-05901-1

Purpose To determine the association of pre-diagnostic allostatic load (AL) with health-related quality of life (HRQOL) among Black women with breast cancer. Methods In a sample of 409 Black women with non-metastatic breast cancer enrolled in the Women’s Circle of Health Follow-Up Study (WCHFS), two pre-diagnostic AL measures were estimated using medical records data from up to 12 months prior to breast cancer diagnosis: AL-lipid/metabolic profile-based measure and AL-inflammatory profile-based measure. HRQOL was assessed approximately 24 months post diagnosis, using the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) instrument, including 5 subscale scores [presented by physical well-being (PWB), social & family well-being (SFWB), emotional well-being (EWB), functional well-being (FWB), and breast cancer-specific scale (BCS)] and 3 derived total scores [presented by trial outcome index (TOI), Functional Assessment of Cancer Therapy-General (FACT-G) and FACT-B]. We used multivariable logistic regression models, using dichotomized AL scores (lower AL: 0–3 points, higher AL: 4–8 points), to assess the associations between the two pre-diagnostic AL measures and HRQOL. Results Higher pre-diagnostic AL was associated with poorer FWB and lower FACT-G, but these associations were statistically significant for the AL-inflammatory profile-based measure (FWB: OR 1.63, 95% CI 1.04, 2.56; FACT-G: OR 1.62, 95% CI 1.04, 2.54), but not the AL-lipid/metabolic profile-based measure (FWB: OR 1.45, 95% CI 0.81, 2.59; FACT-G: OR 1.33, 95% CI 0.75, 2.37). Conclusion These findings suggest that higher AL, particularly when measured using the inflammatory profile-based measure, was associated with poorer HRQOL, namely FWB and FACT-G, among Black breast cancer survivors.